Individual
DONALD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3660 S WEST TEMPLE, SOUTH SALT LAKE, UT 84115-4441
(385) 315-1035
Mailing address
177 W PRICE AVE, SOUTH SALT LAKE, UT 84115-4345
(385) 315-1035
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
CPSS-01611
UT
175T00000X
Peer Specialist
Primary
FPSS-01430
UT
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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